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Humphrey Visual Field Analyzers Innovation and connectivity

Perimetry Brochure

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Page 1: Perimetry Brochure

Humphrey Visual Field Analyzers Innovation and connectivity

Page 2: Perimetry Brochure

// PERIMETRY MADE BY ZEISS

Page 3: Perimetry Brochure

3

Offering the industry’s broadest selection of perimetry products, ZEISS continues to set the gold standard for quality, precision and innovation worldwide.

Humphrey Visual Field Analyzers

Humphrey Field Analyzer: HFA II-i Series

The gold standard with comprehensive connectivity options

Validated by more than 30 years of research, design

and clinical experience, the Humphrey® Field Analyzer

(HFA™) is the accepted standard of care to aid in

glaucoma diagnosis and management. With over

65,000 installed units worldwide, the HFA is the

premier automated visual field analyzer.

Advanced diagnostics and analyses

• Guided Progression Analysis™ (GPA™): The

perimetry progression analysis software identifies

statistically significant change automatically.

• Visual Field Index™ (VFI™): A simple and intuitive

global index to determine percentage of field loss

on every visual field.1,2

• STATPAC™: The language of perimetry compares

results to age-normative and glaucoma databases.

• SITA™: A patented acquisition algorithm for fast

and accurate visual field threshold measurements;

the most commonly used test strategy, incorporates

patient responses in real time.

• Data management connectivity: Patient reports

and other data can be electronically transferred to

ZEISS FORUM® Eye Care Data Management, EMRs

and other data management solutions.

• Gaze tracking: Uniquely tracks patient’s fixation

angle and prints the gaze error to help the doctor

judge test quality.

FORUM Glaucoma Workplace Integrated glaucoma management

• Enables analysis of HFA data within the FORUM Viewer

• Combines structure and function information from the

CIRRUS™ HD-OCT and HFA in one report with FORUM

• Automatically generates reports

(e.g. SFA, Overview, GPA, visual field reports)

• Enables interactive adjustment of GPA parameters

(e.g. change baseline)

• Shows evolution of the GPA triangle plots animated

over time (“cine-mode”)

• Improves patient flow and education

Humphrey Matrix Proven early visual field loss detection, now with connectivity

The Humphrey Matrix® is the ideal solution for busy

practices for case detection and fast threshold testing.

In addition to simplifying visual field testing, numerous

studies show that frequency doubling perimetry can

detect visual field loss missed by other methods.3-6

Humphrey FDT Clinically validated for efficient visual field loss detection

Multiple studies7-21 have shown that the Humphrey

FDT® detects visual field loss due to a variety of ocular

diseases, including glaucoma.

Page 4: Perimetry Brochure

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FORUM Glaucoma WorkplaceStructure and function analysis at your fingertips

Streamline your workflow

HFA analyses in the lane

The ZEISS FORUM Glaucoma Workplace easily allows

you to review and generate HFA reports directly in the

FORUM Viewer. For follow-up visits, a GPA summary can

be automatically produced following 3 or more exams.

And, with just a single click of the mouse, baseline exams

can be changed and outliers removed. Additional to the

GPA screen, an overview of visual field exams is available.

Review and analysis at your fingertips

FORUM gives you on-demand access to visual field data,

OCT scan data, and structure and function results wherever

you are, whenever you want – including your office,

at a workstation, or in the examination lanes.

Better patient flow throughout the office

The FORUM Glaucoma Workplace streamlines your

assessments for more efficient patient flow with no

compromise to the quality of care. Now, instead of

searching through stacks of paper reports, you can

fully focus on the patient examination.

Simplified patient education during the consultation

GPA and Combined Reports from FORUM save you time

and simplify patient consultations, enhancing the patient

education experience and potentially improving compliance.

Review relevant HFA and CIRRUS

data in one combined report

Doctors want the ability to analyze HFA data in their

office. Now, with the FORUM® Glaucoma Workplace

from ZEISS, they have it. The FORUM Glaucoma

Workplace uses the same STATPAC engine as the HFA.

Guided Progression Analysis™ (GPA™) analyses are

automatically performed and instantly available once

three or more exams have been stored. For the first

time, you can change the baselines for GPA analyses

and generate HFA reports from a Mac or PC right in

your practice.

Doctors also want greater integration of HFA

and CIRRUS™ HD-OCT analysis data in a single

report. Here, too, FORUM delivers.

Page 5: Perimetry Brochure

Master your data

FORUM Viewer integration

The FORUM Glaucoma Workplace is a clinical application

that is directly integrated into the FORUM infrastructure.

Advanced user experience

As an integral part of the modern FORUM platform, the

FORUM Glaucoma Workplace lets you take full advantage

of the latest FORUM enhancements and features, giving

you an advanced user experience across all solutions.

Convenient installation

ZEISS service technicians will assist you with all aspects

of the software installation.

Consistent data management

FORUM ensures end-to-end data consistency across

the board – between the HFA, CIRRUS, FORUM and the

FORUM Glaucoma Workplace.

Focus your assessments

Adjust GPA parameters as needed

If necessary, you can adjust GPA parameters by

conveniently changing the baseline, resetting the

baseline after surgery, or excluding any outliers.

Combined structure and function reports

The HFA-CIRRUS Combined Report from FORUM

summarizes patient structure and function analyses in

a single display. FORUM delivers this OD-OS

integration to your lanes to help you assess patient

status at a glance.

Page 6: Perimetry Brochure

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Humphrey Field Analyzer – HFA II-i Series The gold standard with comprehensive data management integration.

Advanced analysis

The HFA is the only perimeter with

progression analysis validated in the

Early Manifest Glaucoma Trial.22

• Enhanced Guided Progression

Analysis (GPA) software identifies

statistically significant progression

automatically, and presents “at a

glance” visual field progression

analysis in a single page report.

• Visual Field Index (VFI) is a simple and

intuitive global index to determine

percentage of field loss.1,2

• Pattern Deviation Plots identify

localized field loss, minimizing ocular

media effects such as cataracts.

• STATPAC, the language of perimetry,

compares results to proprietary age-

normative and glaucoma databases.

// PRECISION MADE BY ZEISS

Complete portfolio of HFA II-i perimeters

Humphrey Field Analyzer II Model 750i

The ultimate for practice efficiency,

advanced features and long-term value.

Humphrey Field Analyzer II Model 745i

All the features of the Humphrey 740i plus

SITA-SWAP software for early detection.

Humphrey Field Analyzer II Model 740i

The basic model in automated visual field

testing for comprehensive care.

Early glaucoma detection

• SITA-SWAP software reduces blue-

yellow threshold test time to just 4–6

minutes, providing a clinically practical

tool for early detection

of glaucoma.23,24

Enhanced exam reliability

• Patented system automatically tracks

and aligns head and eye position.

• Kinetic, Custom and Social Security

Disability testing provide a wide range

of special purpose testing protocols.

• Connectivity to office networks,

EMRs and FORUM® Eye Care Data

Management System.

Page 7: Perimetry Brochure

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GPA – Advancing the science of progression analysis

The HFA Guided Progression Analysis (GPA) software accurately differentiates statistically significant

progression of visual field loss from random variability. The analysis is based upon detailed empirical knowledge of

the variability found at various stages of glaucomatous visual field loss through information acquired in extensive

multi-center clinical trials worldwide.

GPA Summary Report

1

2

3 4

5

6

7

Baseline Exams Establish initial visual field status.

VFI Value A summary measurement of the patient’s visual field status, expressed as a percent of a normal age-adjusted visual field.

2

1

VFI Rate of Progression Analysis Trend analysis of the patient’s overall visual field history.25

VFI Plot Regression analysis of VFI values and 3 to 5 year projection.

VFI Bar A graphical depiction of the patient’s remaining useful vision at the current VFI value along with a 3 to 5 year projection of the VFI regression line if the current trend continues.

5

4

3

Current Visual Field Summary Complete report of current visual field including VFI, MD, PSD, the Progression Analysis Plot and the GPA alert.

GPA Alert A message that indicates whether statistically significant deterioration was noted in consecutive tests.

7

6

Page 8: Perimetry Brochure

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Humphrey Matrix 800 With Frequency Doubling Technology. Proven to find early visual field loss. Quickly. Easily.

Operating a visual field instrument doesn’t get much easier than a Humphrey Matrix. It provides the ideal solution for busy practices for case detection and fast threshold testing. In addition to simplifying visual field testing, numerous studies show that frequency doubling perimetry can detect visual field loss missed by other methods.3-6

Validated clinical performance

• Proven diagnostic performance in

detecting early visual field loss.27,28

• 15% faster threshold testing on

average and up to 70% faster for

more advanced cases.29

• Video eye monitoring and

comfortable chin rest simplify patient

alignment and fixation monitoring.

• Patient-friendly stimulus eliminates

the need for trial lens correction in

most patients.26

Designed for your practice

• HFA-style reports are simple

to interpret.

• Light weight, compact and portable.

• Simple operation.

• Ability to test in normal ambient

light; no darkened room required.

• Connectivity to office networks,

EMRs and FORUM.

// CONFIDENCE MADE BY ZEISS

Page 9: Perimetry Brochure

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Single Field Analysis

Serial Field Overview

Patented Frequency Doubling Technology

The Humphrey Matrix frequency doubling stimulus

can preferentially test for sensitivity loss in the

magnocellular pathways of the visual system.30

Alternating black and white bars create a patient-

friendly doubling illusion. Studies demonstrate

that while all ganglion cell types are affected by

glaucoma, and no single test always identifies the

functional effects of glaucoma first, the Humphrey

Matrix has proven high sensitivity and may find

defects earlier in a unique subset of patients.31,32

Frequency Doubling Stimulus

Page 10: Perimetry Brochure

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// RELIABILITY MADE BY ZEISS

Clinically validated Multiple studies7-21 have shown that the Humphrey FDT detects visual field loss due to a variety of ocular diseases, including glaucoma. The FDT has been clinically validated in more than 170 peer-reviewed publications.

Humphrey FDT Frequency Doubling Technology for efficient visual field loss detection.

Easy to operate and interpret

The FDT is optimized for use in

both ophthalmological and non-

ophthalmological settings and

may be operated by healthcare workers

having little or no specialty training

in ophthalmology.

• Patients may be tested using their

own glasses, no requirement for trial

lenses or eye patches.33

• Short test: ~ 40 seconds per eye.

• Simplified interpretation of results.

• Large, age-related normative database.

• Compact design that fits anywhere

in your practice.

• Easy and intuitive operation for users

of any level of experience.

• Dependable performance in

ambient light.

• Convenient low-cost, built-in printer.*

*FDT does not include electronic connectivity.

Page 11: Perimetry Brochure

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Technical Data Specifications

Specifications FDT Matrix 800HFA II-i

740i 745i 750i

Test specifications

Maximum temporal range (degrees) 30 30 89 89 89

Stimulus duration 200-400 ms 300 ms 200 ms 200 ms 200 ms

Visual field testing distance Infinity Infinity 30 cm 30 cm 30 cm

Background illumination 100 cd/m2 100 cd/m2 31.5 ASB 31.5 ASB 31.5 ASB

Threshold test library

N-30 • •

C-20 •

24-2, 30-2, 10-2, Macula • • • •

60-4, Nasal step • • •

Threshold test strategies

MOBS • •

ZEST •

SITA Standard, SITA Fast, Full Threshold, FastPac • • •

SITA-SWAP Option • •

Screening test library

C40, C64, C76, C80, C-Armaly • • •

C-20 •

N-30 • •

24-2 •

Peripheral test patterns • • •

Screening test modes

Age corrected • • • • •

Threshold related, Single intensity • • •

Specialty test library

Social Security Disability, monocular, binocular • • •

Superior 36, 64 • • •

Kinetic testing Option Option •

Custom testing • • •

Page 12: Perimetry Brochure

Features FDT Matrix 800HFA II-i

740i 745i 750i

Fixation control

Heijl Krakau blind spot monitor • • • • •

Video eye monitor • • • •

Gaze tracking • • •

Head tracking •

Vertex monitoring •

Remote video eye monitor capability • • •

Operator interface

Display LCD LCD Touch-screen LCD

Keyboard • • • •

Stimulus

Frequency doubling • •

White-on-white • • •

Red- or blue-on-white • • •

Blue-on-yellow (SWAP) • •

General testing features

Stimulus sizes 10° 2°, 5°, 10° Goldmann I-V Goldmann I-V Goldmann I-V

Foveal threshold testing • • •

Automatic Pupil measurement •

Test storage

User-defined • • • •

Software features

STATPAC 2–single field analysis • • •

Glaucoma Hemifield Test (GHT) • • • •

Visual Field Index (VFI) • • •

Guided Progression Analysis (GPA) • • •

Serial field overview • • • •

Networking • • • •

FORUM Connectivity • • • •

DICOM Connectivity • • • •

Printer

Thermal printer Native generic PCL 3, PCL 5 and postscript printer support for local, shared and networked printers

Data storage, retrieval and analysis

Hard drive 250 GB 160 GB 160 GB 160 GB

USB • • • •

CD-R/W drive •

Dimensions

Height 17” (43 cm) 17” (43 cm) 23” (58 cm)

Width 10” (25 cm) 12.2” (31 cm) 23” (58 cm)

Depth 19” (48 cm) 33.5” (85 cm) 21” (53 cm)

Weight 19 lbs (8.6 kg) 37.5 lbs (17.4 kg) 88 lbs (40 kg)

Electrical requirements

100-120 V, 50/60 Hz 230 V, 50/60 Hz

100-240 V ~ 50/60 Hz 200 VA max

100-120 V, 50/60 Hz

230 V~, 50/60 Hz, 1.8A

Standards

Meets UL, CSA and CE standards • • • • •

12

Page 13: Perimetry Brochure

Selected references 1 Bengtsson B, Heijl A. A visual field index for calculation

of glaucoma rate of progression. Am J Ophthalmol. Feb 2008;145(2):343-53.

2 Leung CK, Cheung CY, Weinreb RN, et al. Evaluation of retinal nerve fiber layer progression in glaucoma: a study on optical coherence tomography guided progression analysis. Invest Ophthalmol Vis Sci. Jan 2010;51(1):217-22. Epub 2009 Aug 13.

3 Albanis CV, Quinones RA. Use of Matrix Frequency Doubling Technology (FDT) to Assess Visual Field Status Following Unreliable Standard Automated Perimetry (SAP). Invest Ophthalmol Vis Sci. Apr 2008;49:1078.

4 Racette L, Medeiros FA, Zangwill LM, et al. Diagnostic accuracy of the Matrix 24-2 and original N-30 frequency doubling technology tests compared with standard automated perimetery. Invest Ophthalmol Vis Sci. 2008;49:954-960.

5 Sample PA, Medeiros FA, Racette L, et al. Identifying glaucomatous vision loss with visual-function-specific perimetry in the diagnostic innovations in glaucoma study. Invest Ophthalmol Vis Sci. 2006;47:3381-3389.

6 Sample PA, Bosworth CF, Blumenthal EZ, Girkin C, Weinreb RN. Visual function-specific perimetry for indirect comparison of different ganglion cell populations in glaucoma. Invest Ophthalmol Vis Sci. 2000;41:1783-1790.

7 Johnson CA, Samuels SJ. Screening for glaucomatous visual field loss with frequency-doubling perimetry. Invest Ophthalmol Vis Sci. Feb 1997;38(2):413-425.

8 Parikh R, Naik M, Mathai A, et al. Role of frequency doubling technology perimetry in screening of diabetic retinopathy. Indian J Ophthalmol. Mar 2006;54(1):17-22.

9 Realini T, Lai MQ, Barber L. Impact of diabetes on glaucoma screening using frequency-doubling perimetry. Ophthalmology. Nov 2004;111(11):2133-6.

10 Thomas D, Thomas R, Muliyil JP, et al. Role of frequency doubling perimetry in detecting neuro-ophthalmic visual field defects. Am. J Ophthalmol. June 2001;131(6):734-41.

11 Wall M, Neahring RK, Woodward KR. Sensitivity and specificity of frequency doubling perimetry in neuro-ophthalmic disorders: a comparison with conventional automated perimetry. Invest Ophthalmol Vis Sci. Apr 2002;43(4):1277-83.

12 Detry-Morel M, Zeyen T, Kestelyn P, Collignon J, Goethals M. Belgian Glaucoma Society. Screening for glaucoma in a general population with the non-mydriatic fundus camera and the frequency doubling perimeter. Eur J Ophthalmol. Sep-Oct 2004;14(5):387-93.

13 Quigley HA. Identification of glaucoma-related visual field abnormality with the screening protocol of frequency doubling technology. Am J Ophthalmol. June 1998;125(6):819-29.

14 Robin TA, Müller A, Rait J, et al. Performance of community-based glaucoma screening using Frequency Doubling Technology and Heidelberg Retinal Tomography. Ophthalmic Epidemiol. June 2005;12(3):167-78.

15 Iwase A, Tomidokoro A, Araie M, et al. Performance of frequency-doubling technology perimetry in a population-based prevalence survey of glaucoma: the Tajimi study. Ophthalmology. Jan 2007;114(1):27-32. Epub 2006 Oct 27.

16 Saito M, Yamashiro H, Matsumoto H, Shirato S. [Usefulness of frequency doubling technology as a screening test for glaucoma] [Article in Japanese] Nippon Ganka Gakkai Zasshi. Jan 2001;105(1):20-3.

17 Kusaba K, Kawanami M, Ban Y. [The usefulness of frequency doubling technology perimetry in glaucoma screening in health-check program]. [Article in Japanese] Nippon Ganka Gakkai Zasshi. Sep 2004;108(9):554-9.

18 Tatemichi M, Nakano T, Tanaka K, et al. Performance of glaucoma mass screening with only a visual field test using frequency-doubling technology perimetry. Am J Ophthalmol. Oct 2002;134(4):529-37. Erratum in: Sep 2003;136(3):592.

19 Jonas JB, Xu L, Wang YX, et al. The Beijing Eye Study. Acta Ophthalmol. May 2009;87(3):247-61.

20 Thomas R, Naveen S, Nirmalan P, Parikh R. Detection of Ocular Disease by a Vision Center Technician & The Role of Frequency Doubling Technology Perimetry in this Setting. Br J Ophthalmol. Aug 2009 (18): [Epub ahead of print].

21 Wang Y, Xu L, and Jonas JB. Prevalence and causes of visual field loss as determined by frequency doubling perimetry in urban and rural adult Chinese. Am J Ophthalmol. Jun 2006;141(6):1078-1086.

22 Heijl A, Leske MC, Bengtsson B, Hussein M. Measuring visual field progression in the Early Manifest Glaucoma Trial. Acta Ophthalmol Scand. Jun 2003;81(3):286-293.

23 Bengtsson B, Heijl A. Normal intersubject threshold variability and normal limits of the SITA SWAP and full threshold SWAP perimetric programs. Invest Ophthalmol Vis Sci. Nov 2003;44(11):5029-34.

24 Bengtsson B. A new rapid threshold algorithm for short-wavelength automated perimetry. Invest Ophthalmol Vis Sci. Mar 2003; 44(3):1388-94.

25 Casas-Llera P, Rebolleda G, Muñoz-Negrete FJ, Arnalich-Montiel F, Pérez-López M, Fernández-Buenaga R. Visual field index rate and event-based glaucoma progression analysis: comparison in a glaucoma population. Br J Ophthalmol. Dec 2009; 93(12):1576-9. Epub Jun 16 2009.

26 Within ± 3 diopters.27 Medeiros FA, Sample PA, Zangwill LM, et al. A Statistical

Approach to the Evaluation of Covariate Effects on the Receiver Operating Characteristic Curves of Diagnostic Tests in Glaucoma. Invest Ophthalmol Vis Sci. Jun 2006;47:2520-2527.

28 Giuffre I. Frequency Doubling Technology vs Standard Automated Perimetry in Ocular Hypertensive Patients. Open Ophthalmol J. Jan 2009;3:6-9.

29 Patel A, Wollstein G, Ishikawa H, Schuman J. Comparison of Visual Field Defects Using Matrix Perimetry and Standard Achromatic Perimetry. Ophthalmology. Mar 2007;114(3):480-487.

30 White AJ, Sun H, Swanson WH, Lee BB. An examination of physiological mechanisms underlying the frequency-doubling illusion. Invest Ophthalmol Vis Sci. Nov 2002;43(11):3590-9.

31 Sakata LM, DeLeon-Ortega J, Arthur SN, et al. Detecting Visual Function Abnormalities Using the Swedish Interactive Threshold Algorithm and Matrix Perimetry in Eyes with Glaucomatous Appearance of the Optic Disc. Arch Ophthalmol. Mar 2007;125:340-345.

32 Tafreshi A, Sample P, Liebmann J, et al. Visual Function – Specific Perimetry to Identify Glaucomatous Visual Field Loss Using Three Different Definitions of Visual Field Abnormality. Invest Ophthalmol Vis Sci. Mar 2009;50(3),1234-1240.

33 Trial lenses are required beyond ± 3 diopters for the Matrix and beyond ± 7 diopters for the FDT.

Page 14: Perimetry Brochure

Carl Zeiss Meditec, Inc.5160 Hacienda DriveDublin, CA 94568USAwww.meditec.zeiss.com

Humphrey Matrix 800Humphrey Field AnalyzerHumphrey FDT

Carl Zeiss Meditec AGGoeschwitzer Str. 51-5207745 JenaGermany www.meditec.zeiss.com

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CIRRUS™ HD-OCT

Brilliant images and applications for greater glaucoma insight

Humphrey® Field Analyzer (HFA™)

The most advanced and accurate picture of glaucoma functional status and progression

You + ZEISS = Evolving Glaucoma Management

VISUCAM® Digital Fundus Camera

Compact and integrated fundus imaging to visualize and document RNFL and ONH

CIRRUS™ photo

Get the complete picture with the combined OCT and fundus imaging modalities in one system

Humphrey Matrix® 800

Frequency doubling technology detects early loss

FORUM®

Comprehensive eye caredata management for betterworkflow efficiency

“There are multiple challenges for the doctor managing glaucoma: first, is to accurately diagnose and stage glaucoma; and, second, to quickly identify progression in those patients where therapy has been insufficient.”

— Nathan Radcliffe, MD

FORUM